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The article presents a study on the obstacles to self-management of serious mental illness (SMI) and diabetes mellitus (DM). It discusses findings on the domains of barriers to such self-management including personal level barriers such as stress, isolation and stigma, family and community level barriers such as lack of support from family and friends and provider and health care system level barriers such as poor relationships and communication with providers as well as fragmentation of care.

Objectives: To examine management strategies and goals reported by people diagnosed with chronic hepatitis C. Methods: We analyzed data from semistructured interviews (N=42) and from electronic sources [illness narratives (N=79) and Internet threaded discussions (N=264)]. Line-by-line coding, comparisons, and team discussions generated catalogs of lay management strategies and goals. We analyzed code-based files to identify informants' selection of specific strategies for each goal. Results: We classified lay management strategies into 3 categories: medical self-care, behavior change, and coping. These strategies were used selectively In addressing multiple goals, categorized as fighting the virus, strengthening the body, and managing consequences. Conclusions: Results underscore the diversity of strategies for living with a disease characterized by uncertain prognosis and variable expression of symptoms. [ABSTRACT FROM AUTHOR]